A physiotherapy-led early mobilisation protocol for neurosurgical patients with external ventricular drains in intensive care: A service evaluation

Background: An external ventricular drain (EVD) is used to relieve elevated intracranial pressure in neurosurgical patients, and remains in place for an average of 8 days post-surgery. The presence of an EVD poses a major barrier to early mobilisation due to safety concerns. Eligibility criteria published in EVD mobilisation protocols only consisted of parameters related to the neurological system (Moyer et al., 2017; Young et al., 2019). Parameters pertaining to cardiovascular, respiratory and musculoskeletal systems deemed safe for mobilisation were not stated. Aims: To determine the safety, feasibility and effectiveness of implementing an early mobilisation protocol, which included physiological parameters, in patients with EVDs. Methods: A retrospective service evaluation was conducted in a neurological intensive care unit. Medical records were reviewed for 2 periods from October 2017 to March 2018 (pre-protocol period) and October 2019 to March 2020 (protocol period). Eligible patients for out-of-bed mobilisation were screened and identified by physiotherapists. Results: After protocol implementation, there was a 64.8% increase in the proportion of patients with EVDs mobilised (95% CI, 35.9–82.1%, p <0.0001). Median time from EVD placement to 1st mobilisation decreased from 14 to 3.5 days (p <0.0001). Moreover, the median intensive care and hospital length of stays were significantly reduced from 8 to 3.5 days (p = 0.037) and 38 to 22.5 days (p = 0.030) respectively. No adverse events were recorded in the protocol period. Conclusion: The early mobilisation protocol for patients with EVDs enabled safe, feasible and effective mobilisation. Future prospective, controlled research studies are warranted

Innovation spillover, licensing, and ex-post privatization in international duopoly

This paper studies the impact of innovation spillover and licensing on optimal ex-post privatization policies by involving an exogenous R&D activity in a partial-equilibrium international duopoly setting. By assuming a domestic public firm is relatively inefficient compared to its foreign private rival, we characterize and discuss optimal privatization policies under both foreign private and domestic public innovation. The theoretical results suggest that foreign private (domestic public) innovation, including both spillover and licensing, reduces (increases) the optimal degree of ex-post privatization. In addition, innovation spillover and licensing have the same impact direction on privatization policies. The numerical evidence supports these theoretical findings

Innovation spillover, licensing, and ex-post privatization in international duopoly

This paper studies the impact of innovation spillover and licensing on optimal ex-post privatization policies by involving an exogenous R&D activity in a partial-equilibrium international duopoly setting. By assuming a domestic public firm is relatively inefficient compared to its foreign private rival, we characterize and discuss optimal privatization policies under both foreign private and domestic public innovation. The theoretical results suggest that foreign private (domestic public) innovation, including both spillover and licensing, reduces (increases) the optimal degree of ex-post privatization. In addition, innovation spillover and licensing have the same impact direction on privatization policies. The numerical evidence supports these theoretical findings

3,6-Dichloro-N-(4-fluoro­phen­yl)picolinamide

In the title compound, C12H7Cl2FN2O, the dihedral angle between the phenyl and pyridine rings is 42.5 (2) Å and an intramolecular N—H⋯N hydrogen bond occurs. The crystal structure is stabilized by C—H⋯O, C—H⋯F and C—Cl short contacts

2-Chloro-4-fluoro-N-phenyl­benzamide

In the title compound, C13H9ClFNO, the dihedral angle between the two aromatic rings is 13.6 (2)°. In the crystal, the mol­ecules are linked by inter­molecular N—H⋯O hydrogen bonds into chains extending along the c-axis direction

Relationship between Brand Perceptions and Satisfaction: Empirical Study on Skin Products in Malaysia

In the highly competitive marketplace, marketers for the skin care product are facing challenges with identifying the consumer’s brand perception and brand satisfaction. Brand satisfaction is perceived as an important issue on skin care industry. Obviously, customers are the important stakeholders in organizations and their satisfaction is a priority to the company. This study aims to investigate the relationship between brand perceptions and brand satisfaction on skin care products with four independent variables (quality, promotion, image and preference). This study employed the statistic software of SPSS version 19.0 to evaluate 200 sets of questionnaires which collected from students, undergraduates, working adults and other respondents. The findings in this study shows that the brand perceptions on quality, image and preference have positive and significant relationship with brand satisfaction on skin care products. However, the relationship between brand perception on promotion and brand satisfaction is being rejected. Thus, the marketers can focus on perception on quality, image and preference to increase customers’ brand satisfaction to capture and retain them

Duration of untreated bipolar disorder: A multicenter study

Little is known about the demographic and clinical differences between short and long duration of untreated bipolar disorder (DUB) in Chinese patients. This study examined the demographic and clinical features of short (≤2 years) and long DUB (\u3e2 years) in China. A consecutively recruited sample of 555 patients with bipolar disorder (BD) was examined in 7 psychiatric hospitals and general hospital psychiatric units across China. Patients’ demographic and clinical characteristics were collected using a standardized protocol and data collection procedure. The mean DUB was 3.2 ± 6.0 years; long DUB accounted for 31.0% of the sample. Multivariate analyses revealed that longer duration of illness, diagnosis of BD type II, and earlier misdiagnosis of BD for major depressive disorder or schizophrenia were independently associated with long DUB. The mean DUB in Chinese BD patients was shorter than the reported figures from Western countries. The long-term impact of DUB on the outcome of BD is warranted

Three-Dimensional Reconstruction of Thoracic Structures: Based on Chinese Visible Human

We managed to establish three-dimensional digitized visible model of human thoracic structures and to provide morphological data for imaging diagnosis and thoracic and cardiovascular surgery. With Photoshop software, the contour line of lungs and mediastinal structures including heart, aorta and its ramus, azygos vein, superior vena cava, inferior vena cava, thymus, esophagus, diaphragm, phrenic nerve, vagus nerve, sympathetic trunk, thoracic vertebrae, sternum, thoracic duct, and so forth were segmented from the Chinese Visible Human (CVH)-1 data set. The contour data set of segmented thoracic structures was imported to Amira software and 3D thorax models were reconstructed via surface rendering and volume rendering. With Amira software, surface rendering reconstructed model of thoracic organs and its volume rendering reconstructed model were 3D reconstructed and can be displayed together clearly and accurately. It provides a learning tool of interpreting human thoracic anatomy and virtual thoracic and cardiovascular surgery for medical students and junior surgeons

Poly[[tetra­aquatetrakis­[μ3-5-(pyridine-4-carboxamido)­isophthalato]cobalt(II)digadolinium(III)] tetra­hydrate]

In the centrosymmetric polymeric title compound, {[CoGd2(C14H8N2O5)4(H2O)4]·4H2O}n, the GdIII cation is coordinated by one water mol­ecule and four pyridine-4-carboxamido­isophthalate (L) anions in a distorted square-anti­prismatic arrangement, while the CoII cation, located on an inversion center, is coordinated by two pyridyl-N atoms, two carboxyl­ate-O atoms and two water mol­ecules in a distorted octa­hedral geometry. The asymmetric unit contains two anionic L ligands: one bridges two Gd cations and one Co cation through two carboxyl groups and one pyridine-N atom; the other bridges two Gd cations and one Co cation through two carboxyl groups and the uncoordinated pyridine-N atom is hydrogen-bonded to the adjacent coordinated water mol­ecule. Extensive O—H⋯O and N—H⋯O hydrogen bonds are present in the crystal structure